Doctors told to mind their Ps and Qs

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The medieval apothecary weighs out his doses in grains and scruples: modern doctors have been told to keep it simple

You may have long suspected that doctors habitually write and speak in scientific jargon and/or abbreviations that we ordinary mortals cannot fathom.  Whatever your view on that, the profession has now been told to mind its Ps and Qs, and communicate with patients in intelligible plain English.

This guidance comes from doctors’ own governing body, the Royal College of General Practitioners, fearing patients are bewildered by the copies they receive of letters sent by their GP to a consultant. Such referrals may be perfectly correct: but patients cannot understand a word of them.

The news announcement gave rise to numerous enjoyable media anecdotes, mainly about doctors using Latin on prescriptions and medical notes. For instance (I should have said e.g.):

  • a.m.naturally means ante meridiem, in the morning: but what does ac&hs signify? Ante cibum et hora somni, of course: before meals and at bedtime
  • if the doc recommends a cochl, that’s cochleare, a spoonful, a Latin utensil Mary Poppins never filled with sugar, to my knowledge
  • ATC isn’t Latin at all, but a portentous instruction standing for Around The Clock.

You can check these terms in an entertaining list on Wikipedia, which helpfully comments that some terms and measures are now considered anachronistic. In 2018 it’s desirable to use the universal measure of milligrams (mg) for drugs: the old apothecary’s measures of grains and scruples are now obsolete (I suspect my Dad still had to know them when he went to Medical School – in 1939!).

Doctors’ handwriting was legendarily illegible:  mercifully prescriptions are computer-printed nowadays – and, as often as not, emailed directly to the patient’s local pharmacy. Safer, more efficient: but has a little of the magic been (usefully) lost?

I come from a medical family, who never hid behind jargon. When my mum took the phone-calls for my GP Dad, she would report over tea that, “Mrs Robinson phoned in with a case of D&V”. It wasn’t a secret code: we kids knew it meant diarrhoea and vomiting. It was simply technical shorthand. Similarly, a nasty accident might result in a broken “tib and fib”. Nonetheless, Dad always explained things fully to his patients, who held him in the highest regard (I still meet them, and he’s been retired 35 years).

I received what used to be called a privileged and/or classical education. I studied Latin and Greek from an early age, but shockingly learned almost no science. Though biologically illiterate, I confess I like trying to work out what some of those Latin (or even Greek) medical terms mean. Just knowing the technical expression somehow provides comfort.

Perhaps I get that from Dad, who always liked his medical Latin. He still does. Years ago, I asked him about my big toe, whose joint was stiff and painful. “Ah,“ he replied, “that’s a hallux rigidus.”

“What does that mean?” I asked.

“It means you’ve got a big toe joint that’s stiff and painful.” Somehow, that was all I needed: giving it a name helped it get better.

As I hinted on Voice of the North some weeks back, I’ve recently undergone a spinal operation. I was wonderfully cared for, and any technical language used was fully explained. Nonetheless, I was delighted to encounter a bit of Latin in the diagnosis.

Showing us where, on the scan, a nerve was clearly being squeezed by a misshapen disc, the surgeon commented, “It’s close to the cauda equina. That’s what we call the place at the base of the spine where all the nerves spread out to go down the legs: they look like a horse’s tail, a cauda equina.”

He continued: “The need for surgery isn’t urgent, unless something changes. Because of the proximity to the cauda equina, if you suddenly experience incontinence, you must dial 999 immediately.”

Mrs Trafford and I looked at one another, deeply impressed by the offer of such service. After a moment’s thought I replied, “Oh, no, really. If that happens, I think we can clear up the mess ourselves.”

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